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Dietary Changes for Celiac Disease

Celiac disease is a disorder that damages your small intestine and keeps it from absorbing the nutrients in food. Your immune system's reaction to gluten — a protein found in wheat, barley, and rye — causes the damage to your intestinal tract.

When you have celiac disease, gluten causes your immune system to damage or destroy villi, the tiny, fingerlike tubules that line your small intestine. The villi’s job is to get food nutrients to the blood through the walls of your small intestine. If villi are destroyed, you may become malnourished, no matter how much you eat, because you aren’t able to absorb nutrients. Complications of the disorder include anemia, seizures, joint pain, thinning bones, and cancer.

Lifestyle changes to cope with celiac disease

A gluten-free diet is the only treatment if you’ve been diagnosed with celiac disease. You’ll have to avoid gluten for the rest of your life. Even the slightest amount will trigger an immune system reaction that can damage your small intestine. Eating a gluten-free diet requires a new approach to food. A gluten-free diet generally means not eating most grains, pasta, cereals, and processed foods, because they usually contain wheat, rye, and barley. You’ll need to become an expert at reading ingredient lists on packages and choose foods that don’t contain gluten. You can still eat a well-balanced diet with many different foods, including meat, fish, rice, fruits, and vegetables, along with prepared foods that are marked gluten-free.

Gluten-free bread, pasta, and other products have long been available at organic food stores and other specialty food shops. Today, you can find gluten-free products in just about every grocery store, and gluten-free dishes are on menus at all kinds of restaurants.

Tips for following a gluten-free diet

Here are steps to take when getting gluten out of your diet.

Rethink your grains:

Avoid all products with barley, rye, triticale (a cross between wheat and rye), farina, graham flour, semolina, and any other kind of flour, including self-rising and durum, not labeled gluten-free.

Be careful of corn and rice products. These don’t contain gluten, but they can sometimes be contaminated with wheat gluten if they're produced in factories that also manufacture wheat products. Look for such a warning on the package label.

Go with oats. Recent studies suggest you can eat oats as long as they are not contaminated with wheat gluten during processing, but you should check with your doctor first.

Substitute potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour for wheat flour. You can also use sorghum, chickpea or Bengal gram, arrowroot, and corn flour, as well as tapioca starch extract, which act as thickeners and leavening agents.

Check the labels of all foods. Gluten can be found in food items you’d never suspect. Here are some likely to contain gluten:

Beer, ale, and lagers

Bouillon cubes

Brown rice syrup

Candy

Chips, potato chips

Cold cuts, hot dogs, salami, and sausage

Communion wafers

French fries

Gravy

Imitation fish

Matzo

Rice mixes

Sauces

Seasoned tortilla chips

Self-basting turkey

Soups

Soy sauce

Vegetables in sauce

More strategies for a gluten-free lifestyle

Here are ideas to better make the transition to a gluten-free diet:

Separate all kitchen items used for preparing gluten and gluten-free foods, including cooking utensils, cutting boards, forks, knives, and spoons.

When eating out, if you’re not sure about the ingredients in a particular dish, ask the chef how the food was prepared. You can also ask whether a gluten-free menu is available. Most restau­rants have a website where you can review the menu in advance.

Ask your pharmacist if any of your medications contain wheat or a wheat byproduct. Gluten is used as an additive in many products from drugs to lipstick. Manufacturers can provide a list of ingredients upon request if they are not named on the product.

Watch your portion sizes. Gluten-free foods may be safe and good for you, but, alas, they're not calorie-free.

If you still feel symptoms on your gluten-free diet, double check that you're not still consuming small amounts of gluten hidden in sauces, salad dressings, and canned soups or through additives such as modified food starch, preservatives, and stabilizers made with wheat.

As you and your family become experts in reading food and product labels, you’ll be able to detect hidden sources of gluten before they can cause a problem. You might also get more ideas from joining a support group, in person or online, that can help you adjust to your new way of life. These are great forums for learning a wealth of delicious recipes for everything from gluten-free cookies and banana bread to biscuits, trail mix, and grits.